急性心肌梗死及梗死后心衰患者胱抑素C测定的临床意义

目的 探讨急性心肌梗死（AMI）患者及AMI后心衰患者血清Cys C的水平变化情况及其在临床上的应用.方法 选取住院患者133例为研究对象,其中AMI患者61例,AMI后心衰患者72例,67例健康体检者作为对照组.用乳胶增强免疫比浊法检测Cys C,同时检测血清肌酐（Cr）、血尿素氮（BUN）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）及肌钙蛋白（cTnI）和脑钠肽（BNP）等指标,并对检测结果进行统计学分析.结果 Cys C,BUN和Cr在对照组、AMI组和AMI后心衰组组间比较差异有统计学意义（F=16.80-19.68,P＜0.05）;AMI组cTnI水平低于AMI后心衰组（t=2.53,P＜0.05）;AMI组Cys C与BUN,Cr,血管病变支数有相关性（r=0.29-0.72,P＜0.05）;AMI后心衰组Cys C与BUN,Cr,病变支数,cTnI有相关性（r=0.49-0.88,P＜0.05）.AMI组Cys C的ROC曲线下面积0.753（P＜0.05）,AMI后心衰组曲线下面积为0.786（P＜0.05）.结论 Cys C在AMI及AMI后心衰患者中都有所升高,且Cys C增高程度与患者的疾病严重程度及预后有关,Cys C在AMI疾病诊断及预后中有一定的价值.

Clinical Significance of Serum Cyctatin C Determination in Patients with Acute Myocardial Infarction and Post-infarction Heart Failure

Objective To assess the clinical changes and significance of serum cystatin C in patients with acute myocardial in farction and post-infarction heart failure.Methods 133 acute myocardial infarction （AMI） and heart failure after acute myocardial infarction patients diagnosised from June 2012 to July 2013,61 cases of acute myocardial infarction （AMI）,72 cases with heart failure after acute myocardial infarction.67 healthy subjects were enrolled in this study,and detected for plasma levels of Cys C by latex-enhanced turbidimetric immunoassay.Plasm a creatinine,urea nitrogen,TC,TG,HDL,LDL,cTnI and BNP were also detected.All test indexes were analyzed by statistics.Results Plasma Cys C,BUN and Cr levels in con trol group and patients with acute myocardial infarction and post-infarction heart failure groups had significant differences （F 16.80-19.68,P＜0.05）.The serum levels of cTnI in acute myocardial infarction group was lower than post-infarction heart failure group （t 2.53,P＜0.05）.Cys C was positively correlated with BUN,Cr and vascular lesions in patients with myocardial infarction （r 0.29-0.72,P＜0.05）,Cys C was positively correlated with BUN,Cr,vascular lesions and cTnI in patients with post-infarction heart failure （r 0.49-0.88,P＜0.05）.The AUCs of acute myocardial infarction and postinfarction heart failure were：AUC （Cys C） 0.753,（P＜0.05）,AUC （Cys C） 0.786 （P＜0.05）.Conclusions Serum Cys C in patients with acute myocardial infarction and post-infarction heart failure had both the rise,and high Cys C levels associat ed with disease severity and prognosis.Cys C has the certain value in diagnosis and prognosis of AMI disease.